Provider Demographics
NPI:1538663554
Name:OBI, JENNIFER IFEOMA (MD)
Entity type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:IFEOMA
Last Name:OBI
Suffix:
Gender:F
Credentials:MD
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Other - Credentials:
Mailing Address - Street 1:PO BOX 60447
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28260-0447
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6909 PROSPERITY CHURCH RD
Practice Address - Street 2:
Practice Address - City:HUNTERSVILLE
Practice Address - State:NC
Practice Address - Zip Code:28078-6698
Practice Address - Country:US
Practice Address - Phone:704-384-1425
Practice Address - Fax:704-384-1426
Is Sole Proprietor?:No
Enumeration Date:2018-03-23
Last Update Date:2021-08-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC2021-01519207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine